Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. Although it is often used to treat cancer, it is less commonly used to treat cancer of the prostate.

Chemotherapy is mainly used to treat advanced prostate cancer that is no longer being controlled by hormonal therapy (hormone-refractory prostate cancer). It is used in this situation to try to shrink and control the cancer and relieve symptoms, with the aim of prolonging a good quality of life. The chemotherapy drugs are usually given by injection into a vein (intravenously).

Two of the drugs used are docetaxel (Taxotere®) and mitoxantrone.

Sometimes, steroids (such as prednisolone) may be given alongside the chemotherapy.

Chemotherapy drugs can cause side effects, but these can usually be well controlled with medicines. The doctors will look carefully at the possible advantages and disadvantages of chemotherapy treatment for your situation.

Each person's reaction to chemotherapy is different. Some people have very few side effects, while others experience more. The main side effects are described here, along with some of the ways they can be reduced.

Our section on chemotherapy discusses the treatment and its side effects in more detail. Information on individual drugs and their particular side effects is also available.

Lowered resistance to infection

Chemotherapy can reduce the production of white blood cells by the bone marrow, making you more prone to infection. Contact your doctor or the hospital straightaway if:

• your temperature goes above 38ºC (100.5ºF).
• you suddenly feel ill (even with a normal temperature).

You will have a blood test before having more chemotherapy, to make sure that your cells have recovered. Occasionally your treatment may have to be delayed if your blood count is still low.

Bruising or bleeding

Chemotherapy can reduce the production of platelets, which help the blood to clot. Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, blood spots or rashes on the skin, and bleeding gums.

Anaemia (low number of red blood cells)

You may become anaemic. This may make you feel tired and breathless.

Nausea and vomiting

Some chemotherapy drugs can make you feel sick or even be sick. This can be helped by taking antisickness drugs (anti-emetics), which your doctor can prescribe.

Sore mouth

Some chemotherapy drugs can make your mouth sore and may cause small ulcers. Regular mouthwashes are important and the nurses will show you how to do these properly.

Poor appetite

If you don't feel like eating during treatment, you could try replacing some meals with nutritious drinks or a soft diet.

Hair loss

Hair loss is a common side effect of some chemotherapy drugs. This can be very distressing for some people. However, there are many ways of covering up hair loss, including wigs, hats or scarves. You may be entitled to a free wig from the NHS. Your doctor or the nurse looking after you will be able to arrange for a wig specialist to visit you. If you do lose your hair, it should start to grow back within about 3-6 months of the end of treatment.

Tiredness

Chemotherapy affects people in different ways. Some people find they are able to lead a fairly normal life during their treatment, but many find they become very tired and have to take things much more slowly. Just do as much as you feel like and try not to overdo it.

Although they may be hard to deal with at the time, these side effects will gradually disappear once your treatment is over. Your doctor will tell you what to expect from your treatment.